To repeal section 188.027, RSMo, and to enact in lieu thereof six new sections relating to
abortion, with penalty provisions.

Be it enacted by the General Assembly of the state of Missouri, as follows:

Section A. Section 188.027, RSMo, is repealed and six new sections enacted in lieu
thereof, to be known as sections 188.027, 188.108, 334.245, 565.305, 565.310, and 565.315, to
read as follows:

188.027. 1. No abortion shall be performed [except with the prior, informed and written
consent freely given of the pregnant woman.]or induced on a woman without her voluntary
and informed consent, given freely and without coercion. Consent to an abortion is
voluntary and informed and given freely and without coercion, if and only if, at least
twenty-four hours prior to the abortion:

(1) The physician who is to perform or induce the abortion has informed the
woman, orally, reduced to writing, and in person, of the following:

(a) The name of the physician who will perform or induce the abortion;

(b) Medically accurate information that a reasonable patient would consider
material to the decision of whether or not to undergo the abortion, including:

a. A description of the proposed abortion method;

b. The immediate and long-term medical risks to the woman associated with the
proposed abortion method including, but not limited to, infection, hemorrhage, cervical
tear or uterine perforation, harm to subsequent pregnancies or the ability to carry a
subsequent child to term, and possible adverse psychological effects associated with the
abortion; and

c. The immediate and long-term medical risks to the woman, in light of the
anesthesia and medication that is to be administered, the unborn child's gestational age,
and the woman's medical history and medical condition;

(c) Alternatives to the abortion which shall include making the woman aware that
information and materials shall be provided to her detailing such alternatives to the
abortion;

(d) A statement that the physician performing or inducing the abortion is available
for any questions concerning the abortion, together with the telephone number that the
physician may be later reached to answer any questions that the woman may have;

(e) The location of the hospital that offers obstetrical or gynecological care located
within thirty miles of the location where the abortion is performed or induced and at which
the physician performing or inducing the abortion has clinical privileges and where the
woman may receive follow-up care by the physician if complications arise;

(f) The gestational age of the unborn child at the time the abortion is to be
performed or induced; and

(g) The anatomical and physiological characteristics of the unborn child at the time
the abortion is to be performed or induced;

(2) The physician who is to perform or induce the abortion or a qualified
professional has presented the woman, in person, printed materials provided by the
department or an informational video provided by the department, which describes the
probable anatomical and physiological characteristics of the unborn child at two-week
gestational increments from conception to full term, including color photographs or images
of the developing unborn child at two-week gestational increments. Such descriptions shall
include information about brain and heart functions, the presence of external members
and internal organs during the applicable stages of development and information on when
the unborn child is viable. The printed materials or informational video shall prominently
display the following statement: "The State of Missouri wants you to know that the life of
your unborn child began at conception, and that your unborn child has protectable
interests in his or her life, health, and well-being.";

(3) The physician who is to perform or induce the abortion or a qualified
professional has presented the woman, in person, printed materials provided by the
department or an informational video provided by the department, which describes the
various surgical and drug-induced methods of abortion relevant to the stage of pregnancy,
as well as the immediate and long-term medical risks commonly associated with each
abortion method including, but not limited to, infection, hemorrhage, cervical tear or
uterine perforation, harm to subsequent pregnancies or the ability to carry a subsequent
child to term, and the possible adverse psychological effects associated with an abortion;

(4) The physician who is to perform or induce the abortion or a qualified
professional shall provide the woman with the opportunity to view an active ultrasound
of the unborn child and hear the heartbeat of the unborn child if the heartbeat is audible.
The woman shall be provided with a geographically indexed list maintained by the
department of health and senior services of health care providers, facilities, and clinics that
perform ultrasounds, including those that offer ultrasound services free of charge. Such
materials shall provide contact information for each provider, facility, or clinic including
telephone numbers and, if available, web site addresses. Should the woman decide to
obtain an ultrasound from a provider, facility, or clinic other than the abortion facility, the
woman shall be offered a reasonable time to obtain the ultrasound examination before the
date and time set for performing or inducing an abortion. The person conducting the
ultrasound shall ensure that the active ultrasound image is of a quality consistent with
standard medical practice in the community, contains the dimensions of the unborn child,
and accurately portrays the presence of external members and internal organs, if present
or viewable, of the unborn child. The auscultation of fetal heart tone must also be of a
quality consistent with standard medical practice in the community;

(5) Prior to an abortion being performed or induced on an unborn child of twenty-two weeks of gestational age or older, the physician who is to perform or induce the
abortion or a qualified professional has presented the woman, in person, printed materials
provided by the department or an informational video provided by the department that
offers information on the possibility of the abortion causing pain to the unborn child. This
information shall include, but not be limited to the following:

(a) At least by twenty-two weeks of gestational age, the unborn child possesses all
the anatomical structures, including pain receptors, spinal cord, nerve tracts, thalamus,
and cortex, that are necessary in order to feel pain;

(b) A description of the actual steps in the abortion procedure to be performed or
induced, and at which steps the abortion procedure could be painful to the unborn child;

(c) There is evidence that by twenty-two weeks of gestational age, unborn children
seek to evade certain stimuli in a manner that in an infant or an adult would be interpreted
as a response to pain;

(d) Anesthesia is given to unborn children who are twenty-two weeks or more
gestational age who undergo prenatal surgery;

(e) Anesthesia is given to premature children who are twenty-two weeks or more
gestational age who undergo surgery;

(f) Anesthesia or an analgesic is available in order to minimize or alleviate the pain
to the unborn child;

(6) The physician who is to perform or induce the abortion or a qualified
professional has presented the woman, in person, printed materials provided by the
department explaining to the woman alternatives to abortion she may wish to consider.
Such materials shall:

(a) Identify on a geographical basis public and private agencies available to assist
a woman in carrying her unborn child to term, and to assist her in caring for her
dependent child or placing her child for adoption, including agencies commonly known
and generally referred to as pregnancy resource centers, crisis pregnancy centers,
maternity homes, and adoption agencies. Such materials shall provide a comprehensive
list by geographical area of the agencies, a description of the services they offer, and the
telephone numbers and addresses of the agencies; provided that such materials shall not
include any programs, services, organizations or affiliates of organizations that perform
or induce, or assist in the performing or inducing, of abortions or refer for abortions;

(b) Explain the Missouri alternatives to abortion services program under section
188.325, and any other programs and services available to pregnant women and mothers
of newborn children offered by public and private agencies which assist a woman in
carrying her unborn child to term and assist her in caring for her dependent child or
placing her child for adoption, including, but not limited to prenatal care; maternal health
care; newborn or infant care; mental health services; professional counseling services;
housing programs; utility assistance; transportation services; food, clothing, and supplies
related to pregnancy; parenting skills; educational programs; job training and placement
services; drug and alcohol testing and treatment; and adoption assistance;

(c) Identify the state web site for the Missouri alternatives to abortion services
program under section 188.325, and any toll-free number established by the state operated
in conjunction with the program;

(d) Prominently display the statement: "There are public and private agencies
willing and able to help you carry your child to term, and to assist you and your child after
your child is born, whether you choose to keep your child or place him or her for adoption.
The state of Missouri encourages you to contact those agencies before making a final
decision about abortion. State law requires that your physician or a qualified professional
give you the opportunity to call agencies like these before you undergo an abortion.";

(e) Prominently display the statement: "No one can coerce you to have an abortion.
It is against the law for a husband, a boyfriend, a parent, a friend, a medical care provider,
or any other person to coerce you in any way to have an abortion.";

(7) The physician who is to perform or induce the abortion or a qualified
professional has presented the woman, in person, printed materials provided by the
department or an informational video provided by the department explaining that the
father of the unborn child is liable to assist in the support of the child, even in instances
where he has offered to pay for the abortion. Such materials shall include information on
the legal duties and support obligations of the father of a child, including, but not limited
to, child support payments, and the fact that paternity may be established by the father's
name on a birth certificate or statement of paternity, or by court action. Such printed
materials or video shall also state that more information concerning paternity
establishment and child support services and enforcement may be obtained by calling the
family support division within the Missouri department of social services;

(8) The physician who is to perform or induce the abortion or a qualified
professional shall inform the woman that it is unlawful for any person to coerce a woman
to seek or obtain an abortion; and

(9) The physician who is to perform or induce the abortion or a qualified
professional shall inform the woman that she is free to withhold or withdraw her consent
to the abortion at any time without affecting her right to future care or treatment and
without the loss of any state or federally funded benefits to which she might otherwise be
entitled.

2. All information required to be provided to a woman considering abortion by
subsection 1 of this section shall be presented to the woman individually, in the physical
presence of the woman and in a private room, to protect her privacy, to maintain the
confidentiality of her decision, to ensure that the information focuses on her individual
circumstances, to ensure she has an adequate opportunity to ask questions, and to ensure
that she is not a victim of coerced abortion. Should a woman be unable to read materials
provided to her, they shall be read to her. Should a woman need an interpreter to
understand the information presented in written materials or informational videos, an
interpreter shall be provided to her. Should a woman ask questions concerning any of the
information or materials, answers shall be provided in a language she can understand.

3. No abortion shall be performed or induced unless and until the woman upon
whom the abortion is to be performed or induced certifies in writing on a checklist form
provided by the department that she has been presented all the information required in
subsection 1 of this section, that she has been provided the opportunity to view an active
ultrasound image of the unborn child and hear the heartbeat of the unborn child if it is
audible, and that she further certifies that she gives her voluntary and informed consent,
freely and without coercion, to the abortion procedure.

4. No abortion shall be performed or induced on an unborn child of twenty-two
weeks of gestational age or older, unless and until the woman upon whom the abortion is
to be performed or induced has been provided the opportunity to choose to have an
anesthetic or analgesic administered to eliminate or alleviate pain to the unborn child
caused by the particular method of abortion to be performed or induced. The
administration of anesthesia or analgesics shall be performed in a manner consistent with
standard medical practice in the community.

5. No physician shall perform or induce an abortion unless and until the physician
has obtained from the woman her voluntary and informed consent given freely and
without coercion. If the physician has reason to believe that the woman is a victim of a
coerced abortion, the physician or qualified professional shall inform the woman that
services are available for victims of coerced abortion, and shall provide her with private
access to a telephone and information about such services.

6. No physician shall perform or induce an abortion unless and until the physician
has received and signed a copy of the form prescribed in subsection 3 of this section. The
physician shall retain a copy of the form in the patient's medical record.

7. In the event of a medical emergency as provided by section 188.075, the physician
who performed or induced the abortion shall clearly certify in writing the nature and
circumstances of the medical emergency. This certification shall be signed by the physician
who performed or induced the abortion, and shall be maintained under section 188.060.

8. No person or entity shall require, obtain, or accept payment for an abortion from
or on behalf of a patient until at least twenty-four hours has passed since the time that the
information required by subsection 1 has been provided to the patient. Nothing in this
subsection shall prohibit a person or entity from notifying the patient that payment for the
abortion will be required after the twenty-four-hour period has expired if she voluntarily
chooses to have the abortion.

9. The term "qualified professional" as used in this section shall refer to a
physician, physician assistant, registered nurse, licensed practical nurse, psychologist,
licensed professional counselor, or licensed social worker, licensed or registered under
chapter 334, 335, or 337, RSMo, acting under the supervision of the physician performing
or inducing the abortion, and acting within the course and scope of his or her authority
provided by law. The provisions of this section shall not be construed to in any way
expand the authority otherwise provided by law relating to the licensure, registration, or
scope of practice of any such qualified professional.

10. Every abortion facility shall display signs that contain exclusively the following
words: "NOTICE: No one can coerce you to have an abortion. It is against the law for
a husband, a boyfriend, a parent, a friend, a medical care provider, or any other person
to coerce you in any way to have an abortion.". The signs shall be designed and located
so that such signs can be easily read and ensure maximum visibility to women who enter
the abortion facility considering whether to have an abortion; to women at the abortion
facility receiving the information required by this section; and to women at the time that
they give their consent to an abortion. The location of such signs in abortion facilities shall
be specified by rules promulgated by the department and shall be a condition of licensure
of any abortion facility under chapter 197, RSMo. The display of signs under this
subsection does not discharge the duty to conduct an individual private consultation with
a woman considering abortion under subsection 2 of this section.

11. By November 30, 2009, the department shall produce the written materials,
signs, informational videos and forms described in this section. Any written materials
produced shall be printed in a typeface large enough to be clearly legible. All information
shall be presented in an objective, unbiased manner designed to convey only accurate
scientific and medical information. The department shall furnish the written materials,
signs, informational videos, and forms at no cost and in sufficient quantity to any person
who performs or induces abortions, or to any hospital or facility that provides abortions.
The department shall make all information required by subsection 1 of this section
available to the public through its department web site. The department shall maintain
a toll-free, twenty-four-hour hotline telephone number where a caller can obtain
information on a regional basis concerning the agencies and services described in
subsection 1 of this section. No identifying information regarding persons who use the web
site shall be collected or maintained. The department shall monitor the web site on a
regular basis to prevent tampering and correct any operational deficiencies.

12. In order to preserve the compelling interest of the state to ensure that the choice
to consent to an abortion is voluntary and informed, and given freely and without coercion,
the department shall use the procedures for adoption of emergency rules under section
536.025, RSMo, in order to promulgate all necessary rules, forms and other necessary
material to implement this section by November 30, 2009.

188.108. It shall never be a bona fide occupational qualification that an employee
or applicant for employment seek or obtain an abortion.

334.245. 1. Notwithstanding any other provision of law to the contrary that may
allow a person to provide services relating to pregnancy, including prenatal, delivery, and
postpartum services, no person other than a licensed physician is authorized to perform
or induce an abortion.

2. Any person who violates the provisions of this section is guilty of a class B felony.

565.305. As used in sections 565.305 to 565.315, the following words and phrases
shall mean:

(1) "Abortion", the intentional destruction of the life of an embryo or fetus in his
or her mother's womb or the intentional termination of the pregnancy of a mother with an
intention other than to increase the probability of a live birth or to remove a dead or dying
unborn child;

(2) "Abortion facility", a clinic, physician's office, or any other place or facility in
which abortions are performed or induced other than a hospital;

(3) "Coerces a woman to seek or obtain an abortion", performs an act intended to
cause a woman to seek or obtain an abortion against her will, or performs an act
conditioned upon or precipitated by a woman disregarding or refusing a demand that she
seek or obtain an abortion;

(4) "Family or household member", spouses, former spouses, persons related by
blood or marriage, adults who are presently residing together or have resided together in
the past, an adult who is or has been in a continuing social relationship of a romantic or
intimate nature with the victim, and adults who have a child in common regardless of
whether they have been married or have resided together at any time;

(5) "Unborn child", the offspring of human beings from the moment of conception
until birth and at every stage of his or her biological development, including the human
conceptus, zygote, morula, blastocyst, embryo, and fetus;

(6) "Victim of coerced abortion", the victim of the crime of coercing an abortion,
whether or not the victim has reported the crime prior to seeking or obtaining an abortion.

565.310. 1. A person commits the crime of coercing an abortion if the person
knowingly coerces a woman to seek or obtain an abortion by:

(1) Committing, attempting to commit, or conspiring to commit:

(a) An offense defined by any other statute of this state against the woman or her
family or household member;

(b) Assault as defined in section 565.050, 565.060, or 565.070;

(c) Domestic assault as defined in section 565.072, 565.073, or 565.074; or

(d) Stalking or aggravated stalking as defined in section 565.225;

(2) Forcibly or without her knowledge administering to or causing the woman to
ingest any poison, drug, or other substance intended to cause an abortion, or attempting
or threatening to do so;

(3) Discharging, attempting to discharge, or threatening to discharge the female
employee; or changing, attempting to change, or threatening to change her compensation,
terms, conditions, or privileges of employment; or

(4) Revoking, attempting to revoke, or threatening to revoke a scholarship awarded
to the woman by a public or private institution of higher education.

2. Coercing an abortion is classified as follows if it is done by the commission of any
of the acts specified in subsection 1 of this section and the act is otherwise an offense
defined by any other statute of this state:

(1) Class A felony in which the court may impose an additional term of
imprisonment not to exceed ten years, or an additional fine not to exceed ten thousand
dollars, or both, if the offense committed is a class A felony;

(2) Class A felony, if the offense committed is a class B felony;

(3) Class B felony, if the offense committed is a class C felony;

(4) Class C felony, if the offense committed is a class D felony;

(5) Class D felony, if the offense committed is a class A misdemeanor;

(6) Class A misdemeanor, if the offense committed is a class B or C misdemeanor
or an infraction.

3. Coercing an abortion is a class A misdemeanor if it is done by the commission
of any of the acts specified in subsection 1 of this section and the act is not otherwise an
offense defined by any other statute of this state.

4. This section shall not be construed as creating, expanding, or otherwise
endorsing a right to an abortion.

565.315. 1. Any person who knowingly performs or induces or assists in
performing or inducing an abortion on a woman, with knowledge that the predominant
reason the woman is seeking or obtaining the abortion is that the woman is a victim of
coerced abortion, is guilty of a class C felony.

2. Whenever a physician, abortion facility, hospital, or other health care provider
has reasonable cause to suspect that a woman is a victim of a coerced abortion and the
victim is:

(1) A child as defined in section 210.110, RSMo, then a report of suspected abuse
shall be made to the department of social services under section 210.115, RSMo;

(2) A vulnerable person as defined in section 630.005, RSMo, then a report of a
suspected abuse shall be made to the department of mental health under sections 565.218
and 630.163, RSMo;

(3) An adult with a disability as defined by "eligible adult" in section 660.250,
RSMo, then a report of suspected abuse shall be made to the department of health and
senior services under sections 198.070, 565.188, and 660.255, RSMo;

(4) An adult who has been subject to abuse by a present or former adult family or
household member, or who has been the victim of stalking, then the physician, abortion
facility, hospital, or other health care provider shall provide the woman with information
on orders of protection under sections 455.010 to 455.085, RSMo.

3. Under the provisions of chapter 188, RSMo, or any other provision of law
requiring that a woman give her consent freely and without coercion prior to an abortion,
whenever a physician knows that the predominant reason the woman is seeking or
obtaining an abortion is that the woman is a victim of coerced abortion, the physician shall
certify that the woman lacks the consent required by law.